Illinois State Board of Health.

Annual report of Illinois State Board of Health, Volume 5 online

. (page 6 of 89)
Online LibraryIllinois State Board of HealthAnnual report of Illinois State Board of Health, Volume 5 → online text (page 6 of 89)
Font size
QR-code for this ebook


the front, perhaps, as offices, or the rear as dressing rooms. Let
the city itself erect, on some public square, a public building, with
ample halls large and small, to be let to societies or traveling
troupes and lecturers, in which the public health and safety can
be fully cared for. If private parties can provide such halls at a
profit, certainly a city can afford to supply them and take their
revenue. If the city outgrows the one, let it add others at con-
venient points; and if it will provide in these pubhc buildings,
rooms for its offices, for public libraries, museums, scientific and
art collections, for evening schools and lecture courses, it will help
at once the civilization and sanitation of its citizenship. If cities
must exist ; if people will crowd together in great multitudes to live
along the sides of narrow streets, and throng the public places,
they must needs take care, at whatever expense, of that priceless
but perishable good, bodily health.

While our young cities are eager and alert to attract trade and
population, while they welcome capital and business, and pay boun-
ties even for the incoming of manufactories and their crowds of
operatives, let them not begrudge the expenditures to provide for
the preservation of this mass of busy life and strength. Let them
remember that the epidemic which they tempt is the most relentless
of tax-gatherers. The contagions love cities as their warmest
breeding places and richest harvest fields, and the health enfeebled



Digitized by VjOOQIC



XXXll

by public parsimony falls an easier prey to the fiery plague, and
falls as fuel which feeds the flame and speeds its march. Save to-
day your taxes for public health, and to-morrow, or within the year,
they will be demanded of you four-fold for wasted health, for the
buried dead, or for the business ruined by the epidemic scare of
fever or of plague.

The City Board of Health :

An efQcient board of health, with a good competent health offi-
cer, with all needful rules and facilities for the quarantine and care
of those who are suffering from contagious diseases, has also a
place, and a place of indispensable importance in the sanitary re-
quirements. In the case of invasion by contagious disease, the
prompt action of a board of health, with ample and recognized
powers, is the only security against infinite disaster and distress.
But a true board of health will not be merely a '^life-saving ser-
vice," for the occasion of a storm; it will be also the lighthouse to
warn of danger and show the path of safety. The police board,
that watches against crime and defends property, renders a more
obvious, but not a more valuable service than the health board
which watches against the more wasteful desolations of disease, and
guards life itself from the stealthy assault of assassins that lurk in
the tainted air, and breed in neglected sewers and cess-pools.

The members of this important board should be chosen, first, for
their competency, not simply as physicians, but as sanitarians;
and, second, for their energy and activity in public good. And thus
chosen, they should be given ample authority to forbid nuisances
in building and in business; to quarantine and control in con-
tagions and epidemics; to placard all places of danger, and to pro-
vide for the public health. Even despotism may be endured when
the alternative lies between despotism and destruction.

Conclusion :

Other provisions of city sanitation may easily be noticed by the
thoughtful and the expert, but with the fulfillment of those already
named the others will be readily seen and met as they rise. The
health of our State depends largely upon the health of its cities —
those storm-centres of infection and epidemics. The sanitation of
its cities will raise, by natural consequence, the better sanitation of
its country homes and thus of the whole people.



Digitized by VjOOQIC



RtaJULAR QUARTERLY MEETING,

OCTOBEE, 1888.



Held in the office of the Board, in the State House, at Spring-
field, October 5, 1882. Present: Drs. Bateman, Ludlam, Clark
and Bauch. Dr. Bateman presiding in the absence of the President.

After the reading and approval of the minutes of the last meet-
ing, the Secretary submitted the following

QUJIBTERLY REPOBT.*

At the date of last report, June 80, there had been a total of 190
cities, towns and villages in which small-pox had appeared since
November I, 1881, of which number twenty-two had occurred in the
preceding quarter, and there were still cases remaining at nine
points. Since then there have been cases at Paxton, in Ford county,
near Prairie du Bocher, in Bandolph county, and on an island in
the Mississippi river opposite Harrisonville, Monroe county. The
disease has also been re-introduced into Jersey county through a suit
of second-hand clothes bought in St. Louis.

The Paxton cases originated with a stock-dealer and importer of
horses, who contracted the disease en route from France in the
stock-boat Friga, on board of which was a mild case of varioloid.
The boat, it is said, escaped inspection at quarantine in New York,
and as Hefner, the importer, did nbt travel on an immigrant train
in this country, he also escaped the inspection seryice. The disease
was confined to Hefner's house, but his wife, son and daughter were
attacked, and the son died.

The Monroe and Bandolph county cases are believed to have
originated from an infected mattress, supposed to have been thrown
into the river and washed ashore on Staton's Island.! Owing to
failure of prompt recognition of the disease, a hired man who had
been exposed was allowed to go to Bandolph county, near Prairie
du Bocher, where, together with himself, there have been in all
nine cases, with five deaths. The disease seems to have been of a
very mild type oh Staton's Island, no deaths occurring out of the
ten cases.

* Presented in detail, a4 fairly illustrative of the work in the Secretary's o£Sce.
t Subseauentiy ascertained that the contagion was brought from SprinsHeld, Mo. See
Appendix.



Digitized by VjOOQIC



XXXIV

It is worth while calling attention, in this connection, to the
markedly different results obtained in counties under township or-
ganization and in those where, in the absence of town boards, the
county commissioners are charged with the duties of health aathor-
ities. While, of course, the most efficient work is done and the
disease is most promptly '* stamped out*' in localities where there are
regularly organized boards of health, it is yet true that, as a rule,
the town boards have been only less efficient, and the disease has
been generally promptly mastered by their efforts. On the other
hand, in counties where the county commissioners alone have
charge, there has, as a rule, been delay in action or neglect, resulting
in a spread of the contagion beyond the first cases or families and
an undue prolongation of the disease. In Alexander county, for
example, the first case near Commercial Point occurred in the latter
part of April, and the contagion was not finally eradicated until the
20th of July. The recent outbreak and spread in Monroe and Ran-
dolph counties, are, to some extent, due to similar causes.

At this date there is one remaining case near Prairie du Bocher,
and three in the hospital in Chicago. Aside from these, there are
no cases known to exist in the State at present.

The decline of the epidemic in Chicago since the inauguration of
the Immigrant-Inspection Service is clearly shown in the following
table :



Month.



55?


b


CO


■o 55


p


I'






a


;


»21


95


281


65


154


29


44


11


24


5


7


3



Remarks.



April

May

June

July

Auf^ust

September .



Inspection began June 1.
Average decline before inspection.
Average decline since inspection . .



.12 per cent.
.78 per cent.



Immigrant' Inspection Service :

The members of the Board have been supplied from time to time
with my reports, as Supervising Inspector of the I.-I. S. in the
Western District, to the Secretary of the National Board of Health,
and it will, therefore, only be necessary, in this connection, to pre-
sent a summary of the work done up to the close of the quarter,
September 30, 1882, which is as follows:

Immigrants arriving and inspected over the P., Ft. W. & C. E. R,
14,825, of which number 12,676 were more or less perfectly protected,
while 2,1-19 were found to need vaccination or re vaccination.

Over the L. M. & M. S. R. R., arrived and inspected, 11,-102;
protected, 9,3S2; requiring vaccination or revaccination, 2,020.

Over the Michigan Central, 19,131; protected, 14,026; requiring
vaccination or revaccination, 5,105.

Over the Grand Trunk, 8,237 ; protected, 6,486 ; requiring vaccina-
tion or revaccination, 1,751.



Digitized by VjOOQIC



xxsv

Over the Baltimore and Ohio Bailroad, 8,193; protected, 6,418;
requiring vaccination or revaccination, 1,745.

Passing the Indianapolis station for points west, 10,413 ; protected,
9,5o0; requiring vaccination or revaccination, 858.

Crossing the Mississippi at St. Louis, 6,785; protected, 6,440;
requiring vaccination or revaccination, 845.

From the foregoing it will be seen that of the total 78,986 immi-
grants who have arrived in or passed through this district since the
1st day of June, nearly 14,000 were susceptible to small-pox, and
capable of conveying and propagating the contagion throughout the
vast region of the Northwest. As has been before remarked, the
Service is not only a protection to Illinois, but to the entire western
region beyond, north to Minnesota and south to Texas.

Daring the season nine cases of small-pox and varioloid have been
detected and removed from trains before reaching the State, and
within three weeks one case was removed to the Chicago small-pox
hospital by the inspector, and four others were properly cared for
by the St. Louis inspector. The former patient was destined for
Neenah, Wis., and the latter (a party of Bohemians) for Missouri.

Vaccination of School Children :

Daring the last ten days of the quarter, there have been dis-
tributed between 18,000 and 19,000 copies of a circular letter (No.
112) calling attention to the necessity of perfecting and perpetuat-
ing the results of the School-Vaccination Order of the Board, issued
in December last. A copy of this circular has already been sent to
each member of the Board, so that it is probably u^ecessary to add
anything more on this subject.

There will be sent out within a few days, 17,500 copies of the
Vaccination Ketum, Form 52, and some 80,000 Vaccination Certifi-
cates, Form ol, these amounts being still on hand from last winter's
supply.

It may bo incidentally remarked that the necessity for this effort
on the part of the Board, to protect the public- school interests of
the State, will receive very striking proof in the forthcoming history
of the small-pox epidemic of 1831-2, and in the tabulation of the
returns of vaccination from the various schools. It is almost incred-
ible that so large a percentage of unvaccinated children should have
been found as these will show.

Even in Chicago, the tabulation of which has been completed since
the last meeting, a much greater number of imperfectly protected
children were found than was anticipated.

The returns from Cook county alone, including Chicago, have oc-
cupied fully three months in tabulating. The amount of time
required for this work will probably render it impracticable to tabu-
late in such detail the returns from the entire State, but the salient
points, at least, will be collated in due season.



Digitized by VjOOQIC



XXXVl



Vital Statistics :

Daring July the form for the condensed return of deaths, with its
accompanying pamphlet of instructions and list of synonyms, was
distributed to the county clerks. There was also sent to each a
blank (No. I'l) on which to return the totals of marriages, births
and deaths, for the years 1878 to 18S0, inclusive, Form 90 being
reserved for deaths during the year 1831 only.

Up to date, complete return for the four years have been received
from 78 counties, embracing 876 separate returns. From the remaining
29 counties there have been received 179 returns, and it is anticipated
that before the tabulation of those now in hand is completed lull
returns will have been received from all but less than half a dozen
counties.

From such examination of these returns as I have, thus far, been
able to make, it is very apparent that there is not the degree of
attention paid to the law concerning the registration of vital statis-
tics, either on the part of physicians or county clerks, that a com-
monwealth of the general intelligence of Illinois should exhibit.
Something of this is due, no doubt, to the Board itself, which has
hitherto been prevented, by want of means and pressure of other,
duties, from giving the subject the necessary attention; but it is,
also, largely the result of causes which are believed to be now sus-
ceptible of remedy at little cost.

I think it would be well that the Board call the attention of
county commissioners to the importance of this work, to the law
requiring it, and to the necessity of making proper clerical provision
for its execution. Owing to the want of such provision, to failure to
comprehend the character and practical utility of the work, and, in
not a few instances, to ignorance of the legal requirement, the diffi-
culty, labor and expense of securing the returns have been very
considerably enhanced to the Board. Over 500 communications have
been sent out on this one subject alone during the past six weeks.
This, of course, should be entirely unnecessary in a matter which
the law distinctly says the county clerks shall attend to annually.

Litigation, growing out of the want of just such data, frequently
costs a county and private individuals more, in a single year, than
would defray the expense of their collection for a number of years.

Burial-Permit Ordinance:

Of the circular letter and draft of an ordinance concerning burial
permits, authorized to be printed and distributed, there have been
744 copies sent to various persons interested. Its reception has been
quite satisfactory, and letters are now being received in almost every
mail announcing the adoption of the ordinance, or making inquiry
concerning it. A form of permit has been prepared and sent out as
a guide to the officer charged with its issue. This has a counter-
foil or stub attached, which being retained, may constitute the
"suitable book" prescribed in section 4 of the ordinance. The ex-
pense is slight, and the form will answer very well for the smaller
towns. For other places, the book used by county clerks as a reg-
ister of deaths may be used, and this can be obtained at an expense
of from $5 to $10 per copy, according to the number of pages.



Digitized by VjOOQIC



xxxvu

Among the cities and towns which have already adopted the ordi-
nance are Bloomington, Morris, I^eru, Delavan, Pekin, Lemont,
Girard and Canton.

Its importance, as a foundation for a very necessary class of sani-
tary work, can hardly be over-estimated, and I consider it one of
the most satisfactory recent undertakings of the Board.

One of its valuable results will be to facilitate the collection of
vital statistics — a matter which, as shown in another section of this
report, is, at present, very far from perfect.

Prevalent Preventable Diseases:

An examination of the returns of causes of death during the past
year reveals an undue prevalence of such more or less preventable
diseases as typhoid fever, scarlet fever and diphtheria.

While such striking results may not be looked for in any attempts
at the suppression and prevention of these diseases as in small-pox,
still, enough is known of their origin, mode of propagation and the
measures which have proven most successful in combating their
spread, tp warrant the Board in some effort toward popular educa-
tion regarding such measures.

I would suggest that a committee be appointed to prepare a cir-
cular of instruction concerning the prevention 6f these three formid-
able diseases.

Local Boards of Health :

A number of local boards of health have recently been organized
in the State, and, in many instances, have already done effective
work. The want of a uniform code of sanitary ordinances is, how-
ever, seriously felt by these organizations, and hampers their
influence.

I suggest that a committee of this Board be appointed, which,
with the Attorney General, shall prepare such a code, and that the
Secretary be authorized to distribute it, as soon as completed to the
satisfaction of said committee, without awaiting further action by the
Board.

Opposition to Vaccination:

That much discredit has been thrown upon vaccination from
causes entirely foreign to the operation itself, is well understood.
To a very great extent the opposition to the measure is due to these
causes, and the anti-vaccinationists buttress their so-calied argu-
ments with alleged facts which, on investigation, are found to belong
to the post hoc category. A child is vaccinated with a dirty lancet ;
or with virus containing pus globules, epithelial scales, red corpus-
cles, or other foreign matter; or while suflFering from some cutane-
ous disease ; or, being neglected afterward, is exposed to wet, cold
or local irritation and in consequence suffers from a train of unto-
ward symptoms which would as surely follow any simple abrasion
under like conditions. Straightway the case is used to illustrate the
risks, dangers and pernicious effects of vaccination. One or two
such instances in a community have been known to arrest the pro-
gress of vaccination, and to cause an excitement only less harmful
than an outbreak of small-pox itself.



Digitized by VjOOQIC



XXXVUl

The experience of the past year, the data abready accumulated by
the Board, and the desirability of removing any objection to a
measure so beneficent, suggest the propriety of preparing a plain,
simple circular of specific instructions concerning the selection of
virus, the mode of performing the operation, the care to be exer-
cised as to physical condition of the subject, and the precautions to
be observed during the vaccinal disturbance. Such a circular, while
addressed to the laity, would not be without value to the physician
himself, and I recommend the appointment of a committee for its
preparation.

Medical Practice Act:

During the quarter, certificates have been issued to 90 graduates
on recognized diplomas, and 2 to non-graduates on length of practice.

There have also been six certificates issued to midwives, and there
are still remaining in the office the papers of sixteen others to
whom certificates will issue as soon as these are returned with the
necessary signatures of members.

In looking over the results accomplished under the Medical Prac-
tice Act, I have been much impressed by the marked change in the
proportions of non-graduates to graduates. When the law went into
effect in 1877, the best sources of information gave an excess of non-
graduates over graduates, while to-day the proportion is less than
one of the former to five of the latter.

Very many of our licentiates to whom certificates have been issued
upon examination, have complied with the request of the Boabd by
subsequently attending lectures and graduating.

It would be well, I think, to authorize a communication addressed
to all non-graduates under 45 years of age who are practicing under
the 10-years' exemption clause, recommending • their attendance at
some reputable medical school and graduation therefrom. The same
recommendation might also be made to those licentiates upon exam-
ination who have not yet conformed to the expressed wish of the
Board.

With the present advancing standard of medical education, it will
soon be difficult and expensive for members of these two classes to
comply with the technical requirements of good schools, and there
is a rapidly growing tendency to demand the higher qualifications
of such schools, not only from applicants for places of trust and
profit in the public services, but also from the profession generally
by the public at large.

In this connection I am glad to be able to state that the recep-
tion of the Board's schedule of requirements for recognition of
diplomas after the session of 1882-83, has been very generally satis-
factory. The effect of this action will be by no means confined to
the medical schools of our own State, or even those of immediately
adjoining territory, but is already manifest in many of the Eastern
colleges.

While preparing this report, the Cincinnati Lancet and Clinic, of
Sept. 80, comes to hand, containing an editorial in which occur the
following apropos passages:



Digitized by VjOOQIC



xxxix

Some States hare done a ffood work in appointing boards of health and olothinff them
with power to regulate the practice of medicfne. Booh boards have accomplished much
in freeing those Htates from the practice of unqualified men. both native and foreign.

These State Boards have directly el^^vated the standard of mndical education in many
ways. They nay directly to the m(*dical colleges: iTnles!^ you adopt and adhere to a fair
standard of educational and examination requirements we will not recognize your diplo-
mas. While the State of Ohio has no State Board of Health or registration law. neighbor-
ing States having such laws have indirectly caused Ohio cnlleges to advance their re-
quirements for graduation. ♦ ♦♦♦♦♦

Office Work:

Attempts to secure the returns of vital statistics from the county
clerks, to promote the adoption of the burial permit ordinance, to
perfect the history of the small-pox epidemic, and to complete the
returns of the vaccination of public-school children, together with
an unusual amount of routine correspondence, have swelled the
ofi&ce work for the quarter much beyond the average of that for the
summer months usually in the absence of an epidemic.

The following figures indicate, to some extent, the character and
amount of this work:

Received —

Communications, letters, etc 1,890

Eeport of cases, small-pox epidemic, (Form 80) 1,321

Economic reports, smali-pox epidemic, (Form 86) 63

Betums of vital statistics 1,055

School-vaccination returns 172

Registration of certificate returns 243

Sent—

Communications, letters, etc 2,318

Printed circular letters 3,200

Official registers 992

Annual reports 221

Blanks — vaccination certificates 1,550

Blanks— vaccination returns 1,210

Blanks, vital statistics. 1,408

Instructions, vital statistics 190

Burial-permit circular 744

Burial- permit ordinance 425

Burial-permit blanks 130

Immigrant-inspection reports 1,420

School- vaccination circulars 18,425

Certificates issued:—

To graduates 90

To non-graduates 2

To midwives 6

Of the above, 512 packages were sent by express at a cost of
$86.56, and the remainder by mail at a cost of $105.08. There were
also sent 43 telegrams and received 47 — at a cost of $85.06.

In addition to the foregoing work, there has been compiled a com-
plete directory of the diploma-granting medical institutions of the
United States and Canada, showing the organization, course of in-,
struction and requirements for graduation of each of these bodies.
This will be included in the annual report of the Board for 1881,
now going through the press.



Digitized by VjOOQIC



XL



Action on the Secretary's Report:

At the conclusion of the reading of the above it was referred to a
special committee consisting of Drs. Ludlam and Clark« Dr. Clark
was also added to the auditing committee.



AFTERNOON SESSION.

At 2 P. M. the minutes of the morning session were read and
approved.

On motion of the Secretary, the Board went into executive session,
at the conclusion of which the Secretary announced that the follow-
ing orders had been made:

Henry A . Luders, of Colliasville :

In the case of certificate No. 6,256, issued Nov. 1, 1881, to a man
then residing in Chicago, lately at CoUinsville, Madison county, and
claiming to be Henry A. Liiders, a graduate of Gottingen University,
that Eaid certificate be revoked on the ground of fraud, it having
been ascertained by the Secretary that the real graduate of that
name died three years ago.

Joseph Atlierton, oj Leland:

In the case of certificate No. 4,732, issued Oct. 14, 1880, to Dr.
Joseph Atherton, of Leland, LaSalle county, that the Secretary be



Online LibraryIllinois State Board of HealthAnnual report of Illinois State Board of Health, Volume 5 → online text (page 6 of 89)